内耳疾患と免疫異常

Abstract

Three studies were undertaken in order to clarify the incidence of autoimmunity in inner ear diseases.In the first study, the records of 255 patients with Meniere's disease and 127 patients with bilateral sensorineural hearing loss of unknown origin (SNHL) were examined retrospectively for the presence of autoimmune disease. Autoimmune diseases of various types were found in 4.7% of those with Meniere's cases and in 0.8% of those with SNHL.In the second study, 44 patients with unilateral Meniere's disease (unilateral patients), 51 with Meniere's disease with bilateral fluctuant hearing loss (bilateral patients), and 37 SNHL patients were tested for the following : ESR and CRP levels, immunoglobulin levels (IgG, IgM, IgA), complement levels (C3, C3, CH50), and autoantibody levels (rheumatoid factor, anti-DNA antibodies, and antinuclear antibodies).A significantly higher incidence of severe immunologic abnormalities was found in bilateral patients than unilateral or SNHL patients.In the third study, the results of the second study were correlated with inner ear function (hearing levels and caloric test results in Meniere's disease patients, and hearing levels in SN HL patients). Bilateral patients with severe immunologic abnormalities had poorer inner ear function in both ears than did patients with no or slight immunologic abnormalities. No relationship was observed between immunologic abnormality and inner ear function in unilateral Meniere's disease or SNHL.The results of the above investigations indicate the likelihood of autoimmune involvement in certain cases of Meniere's disease with bilateral fluctuant hearing loss, and suggest that Meniere's patients should be examined for immunologic abnormalities.